轻度认知障碍老年人多模式非药物干预依从性的相关因素：一项横断面研究
Correlates of Adherence of Multimodal Non-pharmacological Interventions in Older Adults With Mild Cognitive Impairment: A Cross-Sectional Study.
作者信息
Sun Xue, Wang Lina, Shen Xinhua, Huang Cheng, Wei Zhuqin, Su Liming, Wang Simeng, Liu Xiaoshen, Zhen Xueting
机构信息
School of Medicine, Huzhou University, Huzhou, China.
Department of Neurosis and Psychosomatic Diseases, Third People's Hospital of Huzhou, Huzhou, China.
出版信息
Front Psychiatry. 2022 Jun 3;13:833767. doi: 10.3389/fpsyt.2022.833767. eCollection 2022.
BACKGROUND
Non-pharmacological interventions are promising for delaying cognitive decline in older adults with mild cognitive impairment (MCI). Although some studies have demonstrated adherence rates and factors influencing participation in single modality non-pharmacological interventions, little is known about the level and correlates of adherence to multimodal non-pharmacological interventions (MNPIs) in older adults with MCI.
OBJECTIVE
This study aimed to explore the adherence level and the correlates of adherence to MNPIs in older adults with MCI.
METHODS
A cross-sectional design was employed. Community-dwelling older adults aged 60 years and over were recruited from senior community centers and healthcare centers in Huzhou from March 2019 to December 2020. Data were collected by a general information questionnaire and the adherence scale of cognitive dysfunction management (AS-CDM) in older adults with MCI. Hierarchical regression analyses were applied to explore the correlates of adherence to MNPIs.
RESULTS
A total of 216 completed questionnaires were finally analyzed. Of these, 68.52% were female, and 45.4% of the participants had no less than 6 years of education. The overall mean score for adherence was 117.58 (SD = 10.51) out of 160, equivalent to 73.49 in the hundred-mark system, indicating a medium-level adherence to MNPIs in older adults with MCI. Of the five dimensions of adherence (AS-CDM), self-efficacy scored the highest, and the lowest was perceived barriers. The univariate analysis showed that the factors associated with the adherence to MNPIs were: regular physical exercise, meat-vegetable balance, absence of multimorbidity, high level of education, living alone, and living in urban ( < 0.05). In the hierarchical regression analysis, the final model explained 18.8% of variance in overall adherence ( < 0.01), which high school (Beta = 0.161, < 0.05), college and above more (Beta = 0.171, < 0.05), meat-vegetarian balance (Beta = 0.228, < 0.05), regular physical exercise (Beta = 0.234, < 0.05), and presence of multimorbidity (Beta = -0.128, < 0.05) significantly contributed to adherence. In addition, nearly 80% of older adults with MCI preferred MNPIs.
CONCLUSION
Early assessment and management of adherence to MNPIs were essential in older adults with MCI. Furthermore, the findings shed light on several critical areas of intervention to improve adherence to MNPIs in older adults with MCI.
CLINICAL TRIAL REGISTRATION
http://www.chictr.org.cn/showproj.aspx?proj=35363, ChiCTR1900020950 (Registered on January 23, 2019).
背景
非药物干预对于延缓轻度认知障碍（MCI）老年人的认知衰退具有前景。尽管一些研究已经证明了参与单一模式非药物干预的依从率及影响因素，但对于MCI老年人对多模式非药物干预（MNPI）的依从水平及其相关因素知之甚少。
目的
本研究旨在探讨MCI老年人对MNPI的依从水平及其相关因素。
方法
采用横断面设计。2019年3月至2020年12月，从湖州市的老年社区中心和医疗中心招募60岁及以上的社区居住老年人。通过一般信息问卷和MCI老年人认知功能障碍管理依从性量表（AS-CDM）收集数据。应用分层回归分析来探讨MNPI依从性的相关因素。
结果
最终共分析了216份完整问卷。其中，68.52%为女性，45.4%的参与者接受过不少于6年的教育。在满分160分中，依从性的总体平均得分为117.58（标准差 = 10.51），相当于百分制中的73.49分，表明MCI老年人对MNPI的依从性处于中等水平。在依从性的五个维度（AS-CDM）中，自我效能得分最高，感知障碍得分最低。单因素分析显示，与MNPI依从性相关的因素有：规律体育锻炼、荤素均衡、无多种合并症、高学历、独居和居住在城市（P<0.05）。在分层回归分析中，最终模型解释了总体依从性中18.8%的变异（P<0.01），其中高中学历（β = 0.161，P<0.05）、大专及以上学历（β = 0.171，P<0.05）、荤素均衡（β = 0.228，P<0.05）、规律体育锻炼（β = 0.234，P<0.05）和存在多种合并症（β = -0.128，P<0.05）对依从性有显著贡献。此外，近80%的MCI老年人更喜欢MNPI。
结论
对MCI老年人进行MNPI依从性的早期评估和管理至关重要。此外，研究结果为改善MCI老年人对MNPI的依从性的几个关键干预领域提供了启示。
临床试验注册
http://www.chictr.org.cn/showproj.aspx?proj=35363，ChiCTR1900020950（于2019年1月23日注册）
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